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The Clinical Analysis of Effects of Three Surgical Treatments for Patients with Portal Hypertension

Author: YangPengFei
Tutor: NieWanPin
School: Central South University
Course: Department of General Surgery
Keywords: Portal hypertension Devascularization The joint cavity inside and outside devascularization Transabdominal stapling combined with devascularization Efficacy
CLC: R657.34
Type: Master's thesis
Year: 2008
Downloads: 76
Quote: 0
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Abstract


Objective analysis portal vein hypertension patients simple cardia peripheral vascular disarticulation , combined with devascularization cavity inside and outside the United devascularization different efficacy transabdominal stapling to explore portal hypertension reasonable surgical . Methods A retrospective analysis of the clinical data of 118 cases of hospitalized patients with portal hypertension surgery from March 2002 to October 2007 , of which 46 were implemented simple pericardial blood vessel disarticulation ( devascularization Group ) , 31 cases implementation of the transabdominal stapling joint the devascularization ( staplers group ) , 41 cases combined with devascularization implemented inside and outside the chamber ( chamber inside and outside the group ) . Through detection preoperative , postoperative ( 6-12 months ) serum albumin , serum bilirubin , portal hypertensive gastric mucosal lesions , esophageal varices degree of change observed clinical near-term and long-term efficacy and analysis . Third, the results of the three groups of serum albumin , serum bilirubin before and after surgery showed no significant difference ( P > 0.05 ) , the comparison between the three groups after groups , there was no significant difference ( P > 0.05 ) ; three groups of portal hypertension induced gastric mucosal lesions surgery showed no significant change (P> 0.05), among the 3 groups comparison and there is no significant difference ( P > 0.05 ) ; the three postoperative esophageal varices were improved compared with the preoperative difference was statistically significant (P <0.01), the cavity inside and outside the group and the stapler group esophageal varices disappearance rate ( 91.9% , 92.9% ) significantly better than the the devascularization group ( 4.5%) , the difference was statistically significant ( P <0.01 ) , chamber inside and outside group and stapling group no significant difference (P> 0.05); between the three groups of patients during hospitalization with no deaths , the stapler group postoperative complication rate (61.3 % ) was significantly higher than the devascularization group ( 28.3% ) and inside and outside the chamber group (31.7 %) , the difference was statistically significant ( P <0.05 ) , follow-up of the the devascularization group 2 patients died during , stapler group 1 died cavity inside and outside the group of death cases , postoperative The rebleeding rate cavity inside and outside the group ( 2.7% ) with the stapler group ( 0.00% ) were lower than the devascularization group (13.6%) , the difference was statistically significant ( P <0.05 ) . Conclusion cavity inside and outside the United devascularization from both outside the cavity chamber blocked blood shunt can be more thorough , better to improve the degree of postoperative esophageal varices , reduce postoperative bleeding , and the trauma , fewer complications, wide indications , should be widely applied .

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Liver and liver tube > Portal hypertension
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